Stop Loss Claims Specialist I-Aggregate

Allied; United States; Hybrid; USD 42,000 - 64,000; Full time

Job summary

Allied is seeking a claims specialist to prepare and submit stop loss claim reports and related documents. You will monitor statuses, appeal denials, audit positions, and coordinate with internal teams to resolve issues. The role requires 1–2 years in a self-funded environment and strong Excel capabilities.

The position offers a remote-friendly culture and a collaborative, process-driven environment designed to support success in a flexible work setup.

Qualifications

• 1–2 years of claims experience in a self-funded environment.
• Thorough knowledge of Stop Loss terminologies and concepts.
• Ability to interpret Stop Loss contracts and SPD.
• Proficient with Microsoft Excel (MS Office).
• Strong analytical and problem-solving skills.

Responsibilities

• Compile and submit claim reports and necessary documentation to file stop loss claims
• Monitor claim status and follow up with stop loss carriers
• Appeal denials or reduction of reimbursements by stop loss carriers
• Audit aggregate positions and track funding balance
• Communicate with internal departments to resolve claim issues
• Manage time to file aggregate accommodation, level funded, and final claim submissions

Skills

Analytical thinking

Problem solving

Tools

Microsoft Excel

Job description

Responsibilities

• Compile and submit claim reports and necessary documentation to file stop loss claims
• Monitor claim status and follow up with stop loss carriers
• Appeal denials or reduction of reimbursements by stop loss carriers
• Audit aggregate positions and track funding balance
• Communicate with internal departments to resolve claim issues
• Manage time to file aggregate accommodation, level funded, and final claim submissions

Requirements

• High School diploma or equivalent required
• 1 to 2 years of claims experience in a self funded environment
• Thorough knowledge of Stop Loss terminologies and concepts
• Ability to interpret Stop Loss contracts and Client summary Plan Descriptions (SPD)
• Proficient with Microsoft Office Suite, specifically Microsoft Excel
• Strong analytical and problem solving skills

About the Company

Allied offers a remote-friendly culture that provides flexibility and comfort while ensuring employees are set up for success.